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linear incision, commencing opposite the lower end and on the outer side of the external jugular vein, and about an inch above the clavicle, is carried up- ward for three inches along the exter- nal border of the sterno-cleido-mastoid. The layers of fascia are cut througli to the same extent until the fatty tissue Generic Aygestin over the anterior scalenus is reached. With the fingers the sulcus between the anterior scalenus and the longus colli can be opened up, and the sixth cervi- cal vertebra reached by tearing with a strong director. The artery will gen- erally be found easily, provided no veins are Norethindrone Acetate Tablets injured. If the vessel is not found there, it will be found running up the inner side. The sterno-mastoid and the external and internal jugular veins should be well protected and retracted by good retractors during the Buy Norethindrone Acetate opera- tion, and the wound may be dressed an- tiscptically. To aflTord reasonable hopes of success, the epilepsy must not be al- lowed to become too chronic. Buy Aygestin Online It should be performed as soon as it becomes evi- dent that drugs have no curative effect. In some of the very chronic cases im- provement has resulted, and the author SURGERY. 549 is not yet prepared to say how far that improvement may progress, or how far it may retrogress. Before performing the operation, every external irritating cause should be, as far as possible, re- moved. Not much in this way can always bo done, nor is it necessary, provided it be not one that by its nature or severity is the sole cause of the epilepsy. When the sensibility of tlie epileptic Aygestin Tablets nerve center or cen- ters is reduced, that cause will have no more effect in producing fits than Aygestin Price it has in any other healthy Aygestin Cost non-epi- leptic individual. When the exciting causes of epilepsy are cerebral, and are accompanied or alternate with uncon- trollable anger or maniacal excitement, the effects of operations are not so ap- parent or so permanent. In old-stand- ing cases of chronic epilepsy the opera- tion mitigates the disease, and, the Buy Cheap Aygestin author thinks, may ultimately cure the fits. The after-treatment is of great im- portance. It is well to turn the patients out of the hospital as soon as the wounds have healed. When the fits show signs of recurrence after operation, ice-bags to the spine are valuable. Buy Aygestin The exercise of the patient's faculties and limbs pro- motes the more even distribution of blood through the body. The best re- sults were obtained with those patients who could Aygestin 5mg go home at once after the operation to the comforts and variety of home life. The indolent, objectless life of a hospital ward promotes sensory irritations and digestive disturbances, prolific causes of spinal and cerebral congestions, that probably upset in a very short time all benefit from opera- tion. The author has always made it a rule to ligature both arteries simultane- ously, so that the effect may be as great as possible, and that all that can be done may be done at once. The risk is no greater, but the effect is greater, Aygestin 5 Mg and more apt to be permanent. 14i M. Richelot, in calling attention to the functional state of the leg after fracture of the patella^ dwells particu- larly on the condition of the triceps ex- tensor muscle. His remarks are based upon two cases wliich contrast mark- edly with each other. In one the union of the fragments is good, but the pa- tient is unable to extend the limb. In the other the result obtained by the treatment Aygestin Online of the fracture is not so good, the fragments are farther apart and more movable, and yet the functional state of the limb is much better. In the former the thigh on the affected side measures five centimetres less than on the sound side, while in the latter

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